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Rectal involvement by prostatic carcinoma: barium enema findings
S E Rubesin1, M S Levine, M Bezzi
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
AJR. American Journal of Roentgenology
|January 1, 1989
Summary
Prostatic carcinoma invading the rectum shows varied radiographic features on barium enemas, often presenting as localized rectosigmoid narrowing. Most cases spare the distal rectum, aiding diagnosis.
Area of Science:
- Radiology
- Oncology
- Gastroenterology
Background:
- Prostatic carcinoma can invade adjacent pelvic organs.
- Accurate radiographic assessment is crucial for staging and treatment planning.
Purpose of the Study:
- To identify and describe the radiographic features of prostatic carcinoma invading the rectum using double-contrast barium enemas.
- To correlate radiographic findings with anatomic-pathologic features.
Main Methods:
- Retrospective review of 11 patients with prostatic carcinoma invading the rectum.
- Analysis of double-contrast barium enema findings.
- Correlation with Magnetic Resonance (MR) imaging for anatomic-pathologic basis.
Main Results:
- Radiographic findings included localized rectal narrowing/spiculation (4/11), extrinsic rectosigmoid mass (2/11), umbilicated submucosal mass (1/11), and rectosigmoid narrowing with spiculated folds (4/11).
- 64% of patients demonstrated localized rectosigmoid involvement with distal rectal sparing.
- MR imaging illustrated the anatomic basis for this localized spread.
Conclusions:
- Prostatic carcinoma invading the rectum presents a spectrum of findings on double-contrast barium enema.
- Localized rectosigmoid involvement with distal rectal sparing is the most common presentation.
- Radiographic findings can guide diagnosis and understanding of tumor spread patterns.